Attachment D Vendors Questionnaire for Technical Evaluation.pdf

Atachment D – Vendor’s Ques�onnaire for Technical Evalua�on

For the Technical Evalua�on, annotate the page in your proposal for each of the following:

_____ Twenty-four (24) hour emergency response �me on unan�cipated and/or emergent equipment needs.

Tasks 1 – 8 of the Statement of Work (SOW):

_____ Task 1: Annual quality assurance tes�ng of all diagnos�c x-ray and imaging equipment to (include MRI). Evalua�ons shall be at least annually and no greater than 14 months from previous inspec�on. See Equipment Descrip�on for equipment list.

_____ Task 2: Annual quality assurance tes�ng of mammography equipment. Recer�fica�on of equipment when required.

_____ Task 3: Required physics tes�ng of diagnos�c x-ray and imaging equipment following repairs that could affect pa�ent dosimetry and/or image quality, as needed.

_____ Task 4: Consul�ng services shall be provided as needed to support the VANTHCS Radia�on Safety Office. Consul�ng services include but are not limited to:

• Atend appropriate VANTHCS commitee mee�ngs (i.e., Radia�on Safety Commitee, CT Protocol Commitee, Fluoroscopy Safety Subcommitee, Pa�ent Dosimetry Subcommitee, Radimetrics QA Program) on a quarterly (4), or as needed basis.

• Review of VANTHCS overall technical quality assurance program for diagnos�c x-ray and imaging equipment as requested.

• Perform pa�ent dose evalua�ons, including fetal exposures, as needed and occasionally on an urgent basis.

• Perform personnel occupa�onal dose evalua�ons, as needed.

_____ Task 5: Ini�al installa�on quality assurance tes�ng of all new diagnos�c x-ray and imaging equipment (to include MRI) on an as needed basis. See Future Equipment for es�mated dates of arrival, list is subject to change due to delays, etc.

_____ Task 6: Ini�al installa�on quality assurance tes�ng of new mammography equipment on an as needed basis.

_____ Task 7: Complete structural shielding design plans for the installa�on of new diagnos�c or replacement x-ray and imaging equipment prior to first pa�ent use.

_____ Task 8: Complete radia�on protec�on surveys to verify the adequacy of installed shielding for new and/or refurbished rooms or replacement of equipment prior to first pa�ent use.

Qualifica�ons Diagnos�c Qualified Medical Physicist

_____ Submit a copy of a master’s degree in medical physics, Health Physics, or a related field.

_____ Evidence of current Board Cer�fica�on by the American Board of Radiology (ABR) or American Board of Medical Physics (ABMP). Appropriate subfield is Diagnos�c Medical Physics for ABR cer�fica�on and Diagnos�c Imaging Physics for ABMP cer�fica�on.

_____ Evidence of being Licensed by the State of Texas as a Professional Medical Physicist.

_____ Evidence of mee�ng all NRC, ACR, MQSA, FDA, and TJC requirements for a qualified diagnos�c medical physicist

_____ Resume reflects ten years of experience providing diagnos�c medical physics services, following board cer�fica�on by either ABR or ABMP.

_____ MRI tes�ng, have performed evalua�ons of at least 6 MRI systems under the direc�on of a Qualified Medical Physicist or MRI Scien�st

Qualified Magne�c Resonance Scien�st

_____ Graduate degree in a physical science involving nuclear MR or MRI

_____ Have 3 years of documented experience in a clinical MRI environment

_____ Knowledgeable in the field of nuclear MR physics and familiar with MRI technology, including the func�on, clinical uses, and performance specifica�ons of MRI equipment, as well as calibra�on processes and limita�ons of the performance tes�ng hardware, procedures, and algorithms.

_____ Acknowledgment sta�ng Contractor employees providing services under the supervision or the direc�on of a Qualified Medical Physicist are NOT acceptable (e.g., X-ray technologist) and are NOT permited per VA contract.

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